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Lots of questions!

So, we have finally got to the point where most feeds are mostly pain free, but I'm still having various problems feeding my 13 week old and would be really grateful for any advice.

1. I was expecting that feeds would start to get shorter but instead they have got longer. She regularly takes 35-45 mins per side and she will always take both side if I offer both ( which I do whenever I can). This means feeds are taking 1.5 hours or more. I expected that at the newborn stage but not after 3 months! I don't think it is just because she's comfort sucking - there still lots of swallowing going on towards the end. I almost always take her off my breast once it's clear that she is comfort sucking otherwise we'd be there for even longer! Is it normal for feeds to still take so long?

2. Related to this, I'm concerned that I not feeding her often enough. She sleeps through most nights (eg. 10pm - 6am) and then feeds every 3 or 3.5 hrs but that means only 6 or 7 feeds per day is that enough? She seems happy (mostly) between feeds though there's not a lot of awake non-feeding time! Her weight gain was normal last time we checked.

3. we've had a couple of incidents of mucus in her poo - normal colour (yellow) or a bit green. I know this can be fore/hindmilk imbalance but think that's unlikely as I don't have oversupply and am not cutting feeds short! Is this a worry?

4. She often tugs and squirms during feeds and ends up with a shallow latch as a result. I'll take her off and relatch when this happens but she just squirms off again. Can I help her to stop doing this?

Re: Lots of questions!

The first thing that came to mind for me was that if she's sleeping an 8 hour stretch at night already, she might need to nurse more than "average" in the daytime to make up for it (I don't think most 3-month-olds do 8 hour stretch - let's just say my 3-year-old still doesn't, haha!). So if it seems like she wants to constantly nurse in the daytime, that might be what she needs in order to get enough milk overall. What happens if you offer more often than every 3 or 3.5 hours?

Re: Lots of questions!

Re: Lots of questions!

Nursing sessions generally do start to shorten as baby gets older, But there is a wide range of normal with this, and your baby is still a tiny infant whose main purpose in life is to grow grow grow. And even a much older baby or a toddler will nurse for long periods part of the time. It's normal.

Is nursing uncomfortable for you? Are you feeling stuck in one position? Wanting or needing to do other things?

What happens when you end the nursing session? There is no law that says you must allow baby to end the session every time. Nursing is a relationship. It’s about communication. If you are feeling ‘done’ you can let baby know that by gently taking baby off. If baby is still not done, baby will let you know! On the other hand, there is never any harm in letting baby nurse for comfort or nurse for long periods.

Will baby nurse more often? Will baby nurse more at night, if encouraged? Maybe the feedings are a bit longer than average because they are less frequent than average.
Don;t worry about mucous in poo. Baby is healthy so this is fine.

Re: Lots of questions!

We usually get 1-2 dirty nappies/day and probably an additional 3-5 wet ones. Weight gain is slightly on the low side of normal last time we checked (about 2 weeks ago) but healthcare professionals are not concerned.

I haven't tried nursing more often at night - I'm too busy sleeping! I'm all too aware that the sleeping through might not last so I'm trying to make the most of it while it lasts. If she does wake up in the night, I do feed her though. Should I be waking her to nurse at night?

As for nursing more in the day, I do feel like I'm not getting much else done. I know this is normal to some extent but I do need to get chores done, have the odd shower, and get out of the house sometimes for my own sanity! I do offer if she seems unhappy and nothing else helps though, even if it has been less that 3 hrs (and she ALWAYS takes it!). I think I find the lack of any pattern more frustrating that the among of time it takes, especially as daytime naps are very unpredictable. If I knew I'd have a given amount of time to get things done at a given time of day, that would help enormously.

Feeding is not always comfortable for me but it is such a vast improvement on the first 10-11 weeks that I'm not complaining too much! I'm much happier to let her suck for comfort now, though not if I've been sitting there for over an hour!

Re: Lots of questions!

Since her weight gain is a bit low, I think it's a good idea to start waking her at night. Just 1-2 extra feedings during the nighttime hours could represent a lot of additional calories. Are you using any sleep-extending strategies like swaddling, letting baby sleep in a swing, or giving baby a pacifier at night? If you are, I think now would be a good time to take those things away.

You're totally right that it's normal- and frustrating!- to not be getting much done aside from nursing the baby. Especially when feedings are very long. You might want to try something called switch nursing, where you watch baby very carefully as she nurses, and as soon as she transitions from very active suckling to shallower, fluttery, comfort sucking you take her off the breast and switch her to the other side, and you repeat the process until baby will either no longer latch on (too full!) or is completely asleep. Switch nursing is very good for supply and can help slow feeders get more eating done in less time.

Shallowing up a latch is something that a baby may do by accident, when the heavy breast pulls down on her small mouth and the baby loses her grip, or she may doit on purpose to control the flow of milk. You might want to experiment with different nursing positions- reclined positions are great because gravity hold baby on the breast- and also try supporting the breast using a rolled up washcloth or your hand. If the baby is shallowing her latch on purpose, to deal with fast flow speed issues, then the first thing to try for that is using reclined nursing positions and also to nurse more often, since small, frequent feedings mean that the breast fills up less in between nursing sessions, resulting in slower letdowns.

Re: Lots of questions!

Yes I agree with mommal and she has excellent suggestion re switch nursing, sleep extenders, and position and latch.

If weight gain was great, I would not worry. And 'slow' gain may indeed be totally fine and normal, but I don't want you to go in for your next appt and the hcp is no longer fine with it and puts baby on formula! I have seen this happen many times. Nursing just a tad more often, even if it means adding a session overnight, is almost always the simplest and healthiest way to get more calories into baby. plus it keeps milk production in good shape. if you decide to try a feed after the 10 pm sleep stretch starts, you may be able to nurse baby without waking baby.

You also could consider having breastfeeding assessed by an IBCLC. Latch pain/discomfort + long nursing sessions + slow weight gain may suggest there is a milk transfer issue-baby has difficulty extracting milk. Again, all may be normal as well, just a thought.

Re: Lots of questions!

Thanks for the advice. We have had numerous consultations with various people including an IBCLC due to pain and nipple damage in the first 10 weeks or so. The verdict was always latch problems but not obvious or easily fixed ones! The possibility of mild high arched palate was mentioned by someone though not really discussed properly, so I don't know what the implications of that would be. It's definitely not tongue tie.

I will certainly try switch nursing. I want to avoid making a habit of feeding her to sleep though as we'd like her to be able to go (back) to sleep on her own sometime soon. I will try waking her briefly when I put her down though. We do swaddle her at night but no dummies or swings. We will consider stopping this, though I have to say I don't cope very well with sleep deprivation! Because of the difficulties/pain we've had, I get up to feed her in the night so I think we would both wake up properly, unfortunately. Co-sleeping isn't really an option for us for various reasons.

I use breast compressions inconsistently as I find it a bit uncomfortable for my arm/hand and also I like to have one hand free to get other things done! Also I find it kind of hard to do them in public whilst remaining reasonably discreet. I'm happy nursing in public but don't like drawing attention to myself whilst doing so.

I have tried other positions but really don't find them comfortable - especially not reclining as I can't see what she's doing and I find it hard to get her in a position where I don't have to fully support her. Also my breasts are quite small and soft so they kind of disappear ifI lie back, making it harder for her to latch on well. But maybe I should try it again. It doesn't help that my parents in law are visiting at the moment, making it hard to just make myself comfortable because I'm slightly worried about being a bit discreet!

As for her weight gain, here in the uk they seem pretty relaxed about how often she's weighed - the last couple of times it's only happened because I requested it! So I doubt anyone will force us to put hr on formula, though of course I want to make sure she's getting enough to eat!

Re: Lots of questions!

It is amazing you have battled through so many issues in order to nurse your baby. Obviously you must do what works best for you and your family.

Just a few thoughts- By nursing your baby, you are giving her everything she needs. Love, comfort, a strong, healthy attachment to you, the best nourishment there is…everything you possibly can be doing at this point, to ensure her physical, psychological, and emotional health for her lifetime, you are doing while you nurse your baby.

It is normal for babies, even much older than yours, to need some nighttime comforting no matter how they are fed. This is why mommies need naps. No one deals well with the normal sleep deprivation of new parenthood at first. Your brain kind of adjusts, overtime, usually. But naps are an important survival technique. No need to nap daily if that does not work for you, but maybe as needed? With my oldest I napped every day. Oh I loved my naps. But with my third, I can’t do that, so I try to get a weekend nap in at least.

If you cannot see your baby when reclining you may be reclining to far back. All reclining means is, not sitting ramrod straight up. It can be that you are just leaned back slightly, with good support-a couch or chair back, piles of cushions, whatever. And baby can be in any position. So it takes a little practice and of course no need to nurse in this position if it is not working for you, but it can be very nice for getting a little shut eye while baby nurses secure in your arms on top of you. Also some moms find they prefer to latch baby while sitting up and then relaxing back.

What about side lying, maybe for naps, if nighttime bed sharing does not work for you?

There is not need to do breast compressions for an entire feeding or every feeding. Just as it works for you. Also it can be as simple as a single squeeze for when baby slows down, to get baby revved up again. In other words, no need to do them exactly as described by Newman. He learned about them by watching women do this naturally/organically. All this stuff about breastfeeding that experts throw at moms are just suggestions, and are very adjustable depending on you and your baby.

It doesn't help that my parents in law are visiting at the moment, making it hard to just make myself comfortable because I'm slightly worried about being a bit discreet!

UGH! no that does NOT help. I have a policy of nursing where I want in my home and if anyone is uncomfortable, they are welcome to leave the room. But have you practiced in front of a mirror or a friend? Usually, unless someone is really staring, it is very hard to see anything!

Re: Lots of questions!

Can you go into the reasons why co-sleeping isn't an option? Sometimes there's an element of your sleeping situation that is open to change, if you look at it the right way... For example, I remember one mom posting here, just freaking out that her co-sleeping baby was rolling and was going to roll right out of bed. Solution: mattress on the floor! The mom hasn't even considered that option. It's probably not that simple for you, but you never know...